gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Improvement in quality – reduction of costs: clinical pathways prove cost-effectiveness of neuronavigation

Verbesserung der Behandlungsqualität und Reduktion der Therapiekosten durch Neuronavigation. Eine Analyse des Behandlungspfades

Meeting Abstract

  • corresponding author M. Jung - Alfried Krupp von Bohlen und Halbach Stiftungslehrstuhl für Medizin-Management, Universität Duisburg-Essen
  • K. Böchers - Alfried Krupp von Bohlen und Halbach Stiftungslehrstuhl für Medizin-Management, Universität Duisburg-Essen
  • J. Wasem - Alfried Krupp von Bohlen und Halbach Stiftungslehrstuhl für Medizin-Management, Universität Duisburg-Essen
  • D. Stolke - Klinik und Poliklinik für Neurochirurgie, Universität Duisburg-Essen
  • T. Gasser - Klinik und Poliklinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 022

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc277.shtml

Veröffentlicht: 11. April 2007

© 2007 Jung et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: The neurosurgical treatment of cerebral gliomas (ICD-C 71.9) may be characterized by two microsurgical procedures: the neuronavigated and the non-neuronavigated one. The differences in clinical processes, in quality and costs can be visualized by constructing clinical pathways. These pathways allow an exact definition of the actual treatment costs and help to define measurement categories. The purpose of this study was to evaluate the specific treatment costs of each of the two procedures.

Methods: Clinical pathways for the treatment of cerebral gliomas were designed for the Department of Neurosurgery, University of Duisburg-Essen for the year 2006, focusing on all cost-generating positions. At first we analysed ex-post the patient documentation. More information was generated trough face-to-face interviews with all parties concerned in the treatment. Additionally, we accompanied patients during the whole hospital stay in order to validate the clinical pathways which we have built. Our calculations of the pathway costs were designed in accordance to the mipp©-modell (Modell Integrierter Patientenpfade), which has been developed by the hospital of Aarau, Switzerland.

Results: The costs of the two methods have been calculated separately. Thus a cost comparison of the procedures was possible and statements about the DRG-cost recovery were made. Contrary to general expectation, the neuronavigated procedure is less cost-intensive than the conventional one.

Conclusions: Clinical pathways can merge the interests of people with a medical and an economical background in order to improve treatment quality and to enhance cost-structures of complex treatments. The current data demonstrates that the higher initial expenditure of acquiring a neuronavigation system will be indirectly reimbursed as it decreases the overall treatment costs.